[Barcelona from the Swiss viewpoint].
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Biomedical subjects
Publications and source records attributed to B Segesser.
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The biomechanical approach to the characteristics of load on the ankle joint and the surrounding structures allows a better understanding of the cause and effect of externally acting forces in human movement (walking, running, jumping). This detailed understanding of the mechanics involved (not only in the functional anatomical sense) makes preventive measures possible that can reduce the risk of distortion at the ankle. With the same mechanical models, clinically applicable methods allow biomechanically monitored rehabilitation. The case studies reported here illustrate that therapeutic success can be measured objectively, leading to improvement in therapy and in the ability to make decisions in the clinical environment.
Two sets of concepts for sport shoe construction are discussed, based on anatomical, orthopedic, and epidemiological considerations: one for the prevention of excessive load and related injuries, and one for the improvement of performance. The proposed concepts for prevention of excessive load and related injuries in the foot and the lower extremities are cushioning, support, and guidance. The goals outlined in the concepts can be achieved by altering the material properties or the construction of the shoe. It is suggested that the concept "cushioning" is not well understood yet and needs further research. The discussed concepts for improving performance are first, that energy should be returned at the right location, at the right time, with the right frequency, and second, that loss of energy should be minimized. Reduction of energy loss is an important concept for performance. The concept "return of energy" seems inappropriate for sport shoes.
In recent years several construction elements resulted in an increasing stiffening of the sport shoe so that the foot was partly forced to make its own movements inside the shoe. A new sport shoe concept is presented basing on the results of anatomic and biomechanical studies, its innovative feature being decoupling of the foot movement between the calcaneal part of the foot and the metatarsus (= torsion). The foot is given an opportunity to transmit its freedom of movement in the longitudinal axis of the foot to the shoe without the shoe acting as a lever, this goal being achieved by a limited liberation of the metatarsal pronation/supination and a controlled uncoupling of the metatarsus from the calcaneal part of the foot.
The purpose of this paper is to discuss the influence of playing surfaces on the forces and moments acting on the human body and the injuries they may cause for 2 selected sports activities, American football and tennis. The review is based on data from the literature and from our own investigations. A review of the effect of sports surfaces on injuries in American football leads to the conclusion that surfaces with artificial turf produce non-severe injuries more frequently than surfaces with natural grass. However, severe injuries seem to occur as frequently on natural grass as on artificial turf. It has been speculated that the shoe-surface combination which determines the frictional forces is connected with the injury frequency, i.e. the higher the frictional resistance the higher the injury frequency. Tennis surfaces have been shown to influence the occurrence and frequency of tennis injuries dramatically. The injury frequency on 'clay' and 'synthetic sand' is significantly lower than on other selected artificial surfaces. It is speculated that the differences in injury frequency are directly related to the differences in the frictional properties of the surfaces. Surfaces with low frictional resistance are assumed to cause fewer injuries than surfaces with high frictional resistance. In general, it can be concluded that the frictional property of a surface is one of the main factors to be considered when studying the aetiology of acute and/or chronic pain and injury in sports. Compliance or stiffness of surfaces, surprisingly, could not be related to the frequency of injuries on particular playing surfaces. However, it is speculated that compliance properties of surfaces are a factor which must be considered when studying chronic injuries.
Today children wear sport shoes more and more on a daily basis, although the sport shoe was originally designed to serve just for sports purposes. Good sport shoes for children must therefore fulfill the criteria for everyday shoes as well as the requirements for good running shoes, namely, adequate cushioning in the heel area, support during pronation and directing the rolling movement for push-off using the forefoot. For these purposes, the shoe should not represent a miniaturized version of an adult sport shoe, but must be designed for the form of the child's foot and also take the fragility of the connective tissue into consideration, in addition to user comfort, fit, and foot ventilation. In comparison with today's models, therefore, good sports shoes could be improved in many areas.
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The risk of injury during landing after a jump is considered high, because large moments can force the foot into a distortion. The goals of this investigation were to measure the foot-movements during landing and to check the hypothesis, whether with changes at the shoe sole the rearfoot can be brought into a vertical and therefore stable position during the landing movement. The results show, that during landing the foot twists between forefoot and rearfoot. This movement is referred to as torsion and is described in detail in the anatomical literature. With grooves in the shoe sole the torsion with shoes comes closer to the barefoot values. The rearfoot is stabilized by 5-10 degrees and the risk of injury is decreased.